Hostname: page-component-7b7567c8c-tnzcf Total loading time: 0 Render date: 2026-11-13T21:07:52.334Z Has data issue: false hasContentIssue false
  • English
  • Français

The effectiveness of a program of physical activity and diet to modify cardiovascular risk factors in patients with severe mental illness after 3-month follow-up: CAPiCOR randomized clinical trial

Published online by Cambridge University Press:  30 October 2015

R. Masa-Font,
M.I. Fernández-San-Martín,
L.M. Martín López,
A.M. Alba Muñoz,
S. Oller Canet,
J. Martín Royo,
L. San Emeterio Echevarría,
N. Olona Tabueña,
M. Ibarra Jato and
A. Barroso García
...Show all authors
R. Masa-Font*
Affiliation:
EAP Besòs, Institut Català de la Salut (ICS), C/Alfons el Magnànim 57, 08019Barcelona, Spain
M.I. Fernández-San-Martín
Affiliation:
Unitat Docent de Medicina Familiar i Comunitària C/Sardenya 375, 08025Barcelona, Spain
L.M. Martín López
Affiliation:
Centre Institut de Neuropsiquiatria i Addiccions (INAD), Parc de Salut Mar Hospital del Mar, Passeig Marítím, 25-29, 08003Barcelona, Spain
A.M. Alba Muñoz
Affiliation:
Centre Salut Mental Ciutat Vella, Parc Sanitari Sant Joan de Déu, C/Via Laietana 19, 08003Barcelona, Spain
S. Oller Canet
Affiliation:
Centre Salut Mental Martí i Juliá (INAD), C/President Lluís Companys 8, 08921Santa Coloma de Gramenet, Spain
J. Martín Royo
Affiliation:
CUAP Casernes (ICS), C/Fernando Pessoa 47-51, 08030Barcelona, Spain
L. San Emeterio Echevarría
Affiliation:
Centre Salut Mental Sant Martí Nord (INAD), Pl Infància, s/n, 08020Barcelona, Spain
N. Olona Tabueña
Affiliation:
Àmbit d’Atenció Primària Barcelona Ciutat, Unitat d’Avaluació, Sistemes d’Informació i Qualitat, C/Numància 23, Barcelona, Spain
M. Ibarra Jato
Affiliation:
Centre Salut Mental Sant Martí Nord (INAD), Pl Infància, s/n, 08020Barcelona, Spain
A. Barroso García
Affiliation:
EAP Sant Martí (ICS), C/Fluvià 211, 08020Barcelona, Spain
S. González Tejón
Affiliation:
EAP Raval Sud (ICS), Av/Drassanes 17-21, 08001Barcelona, Spain
C. Tajada Vitales
Affiliation:
EAP Doctor Vilaseca (Can Mariner), C/Sant Carles 79, 08921Santa Coloma de Gramenet, Spain
B. Díaz Mújica
Affiliation:
Centre Salut Mental Sant Martí Sud (INAD), Passeig Marítim 25-29, 08003Barcelona, Spain
L. Viñas Cabrera
Affiliation:
EAP Poblenou (ICS), C/Lope de Vega 138, 08005Barcelona, Spain
R. Sanchís Catalán
Affiliation:
Centre Salut Mental Sant Martí Sud (INAD), Passeig Marítim 25-29, 08003Barcelona, Spain
T. Salvador Barbarroja
Affiliation:
Centre Salut Mental Sant Martí Nord (INAD), Pl Infància, s/n, 08020Barcelona, Spain
*
⁎Corresponding author. Tel.: +34 60 55 79 09 9. E-mail address:rosermasa@gmail.com (R. Masa-Font).
Get access

Abstract

Background

The aim of this randomized clinical trial follow-up at three months was to evaluate the effectiveness of an educational intervention with a focus on diet and physical activity (PA) to change the amount of PA, body mass index (BMI) and the waist circumference (WC) in patients with severe mental illness.

Methods

We recruited 332 outpatients with severe mental disorders undergoing treatment with antipsychotic medication from Mental Healthcare Centers of Barcelona. They were randomly assigned to an intervention or a control group. The patients in the intervention group participated in a group PA and diet educational program. The blinded measurements at 0 and 3 months were: the level of PA (IPAQ questionnaire), BMI, WC, blood pressure, dietary habits (PREDIMED questionnaire), quality of life (SF-36 questionnaire) and laboratory parameters (cholesterol, triglycerides, glucose).

Results

The average age was 46.7 years and 55% were males. Schizophrenia had been diagnosed in 67.1% of them. At 3 months, the average weekly walking METs rose significantly in the IG 266.05 METs (95%CI: 16.86 to 515.25; P = 0.036). The total MET average also rose although not significantly: 191.38 METs (95%CI: 1.38 to 381.38; P = 0.086). However, the BMI decreased significantly more in the CG, by 0.26 kg/m2 (95%CI: 0.02 to 0.51; P = 0.038), than in the IG. There were no significant differences in the WC.

Conclusions

The short-term results suggest that the intervention increases the level of PA, but does not improve physical or laboratory parameters.

Trial registration

Clinicaltrials.gov NCT01729650 (effectiveness of a physical activity and diet program in patients with psychotic disorder [CAPiCOR]).

Keywords

SchizophreniaBipolar disorderCardiovascular risk factorsPhysical activityDietQuality of life

Information

Type
Original article
Information
European Psychiatry , Volume 30 , Issue 8 , November 2015, pp. 1028 - 1036
Copyright
Copyright © European Psychiatric Association 2020

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Article purchase

Temporarily unavailable

References

Abbott, M.Arthur, A.Walker, L.Doody, G.. The challenge of recruiting people with schizophrenia to a health promotion trial. Br J Gen Pract 2005;55(517):634–636.Google ScholarPubMed
Aguilar, E.Coronas, R.Caixàs, A.. Síndrome metabólico en pacientes esquizofrénicos con tratamiento antipsicótico. Med Clin (Barc) 2012;139(12):542–546.CrossRefGoogle Scholar
Bellivier, F.. Schizophrenia, antipsychotics and diabetes: genetic aspects. Eur Psychiatry 2005;20(Suppl. 4):S335–S339.CrossRefGoogle ScholarPubMed
Bernardo, M.Grazia, M.. Esquizofrenia y Medicina de Familia. Implicaciones en Atención Primaria. Jano 2008;1714:37–44.Google Scholar
Bobes, J.Arango, C.Aranda, P.Carmena, R.Garcia-Garcia, M.Rejas, J., et al.Cardiovascular and metabolic risk in outpatients with schizoaffective disorder treated with antipsychotics: results from the CLAMORS study. Eur Psychiatry 2012;27(4):267–274.CrossRefGoogle ScholarPubMed
Bou Khalil, R.. Metabolic syndrome in patients with schizophrenia independently from atypical antipsychotics intake. Presse Med 2012;41(5):e238–e243.CrossRefGoogle ScholarPubMed
Casañas, R.Catalán, R.del Val, J.L.Real, J.Valero, S.Casas, M.. Effectiveness of a psycho-educational group program for major depression in primary care: a randomized controlled trial. BMC Psychiatry 2012;12:230. http://dx.doi.org/10.1186/1471-244X-12-230.CrossRefGoogle ScholarPubMed
Compton, M.T.Daumit, G.L.Druss, B.G.. Cigarette smoking and overweight/obesity among individuals with serious mental illnesses: a preventive perspective. Harv Rev Psychiatry 2006;14(4):212–222.CrossRefGoogle ScholarPubMed
Craig, C.L.Marshall, A.L.Sjöström, M.Bauman, A.E.Booth, M.L.Ainsworth, B.E., et al.International Physical Activity Questionnaire: 12-country reliability and validity. Med Sci Sports Exerc 2003;35:1381–1395.CrossRefGoogle ScholarPubMed
Daumit, G.Dickerson, F.Wang, N.Dalcin, A.Jerome, G.Anderson, C., et al.A behavioral weight-loss intervention in persons with serious mental illness. N Engl J Med 2013;368(17):1594–1602. http://dx.doi.org/10.1056/NEJMoa1214530.CrossRefGoogle ScholarPubMed
Estruch, R., et al.Primary prevention of cardiovascular disease with a Mediterranean diet. N Engl J Med 2013;368(14):1279–1290.CrossRefGoogle ScholarPubMed
Faulkner, G.Cohn, T.Remington, G.. Interventions to reduce weight gain in schizophrenia. Cochrane Database Syst Rev 2007;1:CD005148.Google Scholar
Faulkner G1 Cohn, T.Remington, G.. Validation of a physical activity assessment tool for individuals with schizophrenia. Schizophr Res 2006;82(2–3):225–231. [Epub 2005 Dec 19].Google Scholar
Fernández-San-Martín, M.I.Martín-López, L.M.Masa-Font, R.Olona-Tabueña, N.Roman, Y.Martin-Royo, J., et al.The effectiveness of lifestyle interventions to reduce cardiovascular risk in patients with severe mental disorders: meta-analysis of intervention studies. Community Ment Health J 2014;50(1):81–95. http://dx.doi.org/10.1007/s10597-013-9614-6.CrossRefGoogle ScholarPubMed
Firth, J.Cotter, J.Elliott, R.French, P.Yung, A.R.. A systematic review and meta-analysis of exercise interventions in schizophrenia patients. Psychol Med 2015;45(7):1343–1361.CrossRefGoogle ScholarPubMed
Fuller, N.R.Williams, K.Shrestha, R.Ahern, A.L.Holzapfel, C.Hauner, H., et al.Changes in physical activity during a weight loss intervention and follow-up: a randomized controlled trial. Clin Obes 2014;4(3):127–135. http://dx.doi.org/10.1111/cob.12057. [Epub 2014 Apr 23]CrossRefGoogle ScholarPubMed
Guy, W.Clinical global impression (CGI). In: Guy, W. editor. ECDEU assessment manual for psychopharmacology. Rockville: US Department of Health, Education and Welfare, Public Health Service, Alcohol, Drug Abuse and Mental Health Administration, NIMH. Psychopharmacology Research Branch, Division of Extramural Research Programs; 1976. 218–222.Google Scholar
Heggelund, J.Morken, G.Helgerud, J.Nilsberg, G.E.Hoff, J.. Therapeutic effects of maximal strength training on walking efficiency in patients with schizophrenia – a pilot study. BMC Res Notes 2012;5:344. http://dx.doi.org/10.1186/1756-0500-5-344.CrossRefGoogle ScholarPubMed
Holley, J.Crone, D.Tyson, P.Lovell, G.. The effects of physical activity on psychological well-being for those with schizophrenia: a systematic review. Br J Clin Psychol 2011;50(1):84–105.CrossRefGoogle ScholarPubMed
Kazis, L.E.Anderson, J.J.Meenan, R.F.. Effect sizes for interpreting changes in health status. Med Care 1989;27(3 Suppl.):S178–S189.CrossRefGoogle ScholarPubMed
Laursen, T.M.Munk-Olsen, T.Vestergaard, M.. Life expectancy and cardiovascular mortality in persons with schizophrenia. Curr Opin Psychiatry 2012;25(2):83–88.CrossRefGoogle ScholarPubMed
Leese, M.Schene, A.Koeter, M.Meijer, K.Bindman, J.Mazzi, M., et al.SF-36 scales, and simple sums of scales, were reliable quality-of-life summaries for patients with schizophrenia. J Clin Epidemiol 2008;61(6):588–596. http://dx.doi.org/10.1016/j.jclinepi.2007.08.004. [Epub 2008 Feb 14].CrossRefGoogle ScholarPubMed
Llibre blanc. Consens sobre les activitats preventives a l’edat adulta dins l’atenció primària. Barcelona (España): Direcció General de Salut Pública, Departament de Salud, Generalitat de Cataluña; 2005.Google Scholar
Lovell, K.Wearden, A.Bradshaw, T.Tomenson, B.Pedley, R.Davies, L.M., et al.An exploratory randomized controlled study of a healthy living intervention in early intervention services for psychosis: the INTERvention to encourage ACTivity, improve diet, and reduce weight gain (INTERACT) study. J Clin Psychiatry 2014;75(5):498–505. http://dx.doi.org/10.4088/JCP.13m08503.CrossRefGoogle ScholarPubMed
Marshall, M.Barrowclough, C.Drake, R.Husain, N.Lobban, F.Lovell, K., et al.The HELPER programme: HEalthy Living and Prevention of Early Relapse – three exploratory randomised controlled trials of phase-specific interventions in first-episode psychosis. Southampton (UK): NIHR Journals Library; 2015.Google ScholarPubMed
Martinez-Gonzalez, M.A.Fernandez-Jarne, E.Serrano-Martinez, M.Wright, M.Gomez-Gracia, E.Development of a short dietary intake questionnaire for the quantitative estimation of adherence to a cardioprotective Mediterranean diet. Eur J Clin Nutr 2004;58:1550–1552.CrossRefGoogle Scholar
Masa-Font, R.Fernández-San-Martín, M.I.Martín-López, L.M.Olona-Tabueña, N.Oller-Canet, S.San-Emeterio-Echevarría, L., et al.Effectiveness of a program of physical activity and diet to modify cardiovascular risk factors in patients with severe mental illness (CAPiCOR Study): study protocol. Int Arch Med 2015;8(97):1–12. http://dx.doi.org/10.3823/1696.Google Scholar
Medeiros, L.Obiols, J.Navarro, J.B.Zúñiga, A.Metabolic syndrome and health related quality of life in patients with schizophrenia. Actas Esp Psiquiatr 2013;41(1):17–26.Google Scholar
O’Donell, C.J.Elosua, R.Cardiovascular risk factors. Insights from Framingham Heart Study. Rev Esp Cardiol 2006;61(3):299–310.CrossRefGoogle Scholar
Oud, M.Meyboom-de Jong, B.Somatic diseases in patients with schizophrenia in general practice: their prevalence and health care. BMC Fam Pract 2009;10:32.CrossRefGoogle ScholarPubMed
Poulin, M.J.Chaput, J.P.Simard, V.Vincent, P.Bernier, J.Gauthier, Y., et al.Management of antipsychotic-induced weight gain: prospective naturalistic study of the effectiveness of a supervised exercise programme. Aust N Z J Psychiatry 2007;41:980–989.CrossRefGoogle ScholarPubMed
Sáiz, J.Bobes, J.Vallejo, J.Giner, J.García-Portilla, M.P.Grupo de Trabajo sobre la Salud Física del Paciente con Esquizofrenia. Consensus on physical health of patients with schizophrenia from the Spanish societies of Psychiatry. Actas Esp Psiquiatr 2008;36:251–264.Google Scholar
Salas-Salvadó, J.Rubio, M.A.Barbany, M.Moreno, B.Grupo Colaborativo de la SEEDO. Consenso SEEDO 2007 para la evaluación del sobrepeso y la obesidad y el establecimiento de criterios de intervención terapéutica. Med Clin (Barc) 2007;128(5):184–196.CrossRefGoogle Scholar
Scheewe, T.W.Backx, F.J.G.Takken, T.Jorg, F.Van Strater, A.C.P.Kroes, A.G., et al.Exercise therapy improves mental and physical health in schizophrenia: a randomised controlled trial. Acta Psychiatr Scand 2013;127:464–473.CrossRefGoogle ScholarPubMed
Ter Meulen, W.G.de Haan, L.Exercise-promoting interventions for encouraging people with schizophrenia to take physical exercise. Tijdschr Psychiatr 2012;54(8):741–746.Google ScholarPubMed
Tsoi, D.T.Porwal, M.Webster, A.C.Interventions for smoking cessation and reduction in individuals with schizophrenia. Cochrane Database Syst Rev 2010;6:CD007253.Google Scholar
Vilagut, G.Ferrer, M.Rajmil, L.Rebollo, P.Permanyer-Miralda, G.Quintana, J.M., et al.El Cuestionario de Salud SF-36 español: una década de experiencia y nuevos desarrollos. Gac Sanit 2005;19(2):135–150.CrossRefGoogle Scholar
Viñas, L.Fernández, M.San Emeterio, L.Martín-López, L.M.Grup Psicosi Litoral. Detección de factores de riesgo cardiovascular en pacientes con psicosis. Aten Primaria 2011;43(7):386–387. http://dx.doi.org/10.1016/j.aprim.2010.04.021.CrossRefGoogle Scholar
Viron, M.Baggett, T.Hill, M.Freudenreich, O.Schizophrenia for primary care providers: how to contribute to the care of a vulnerable patient population. Am J Med 2012;125(3):223–230.CrossRefGoogle ScholarPubMed
Submit a response

Comments

No Comments have been published for this article.